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Barriers to optimal pain management in aged care facilities: an Australian qualitative study

Veal, FC ORCID: 0000-0001-9018-1965, Williams, M ORCID: 0000-0002-5589-182X, Bereznicki, L ORCID: 0000-0003-3974-3437, Cummings, EA ORCID: 0000-0001-6501-7450, Thompson, A ORCID: 0000-0001-8677-0249, Peterson, G ORCID: 0000-0002-6764-3882 and Winzenberg, T ORCID: 0000-0002-4112-3491 2017 , 'Barriers to optimal pain management in aged care facilities: an Australian qualitative study' , Pain Management Nursing, vol. 19, no. 2 , pp. 1-9 , doi: 10.1016/j.pmn.2017.10.002.

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Abstract

Up to 80% of residents in aged care facilities (ACFs) experience pain,which is often suboptimally managed. To characterize pain managementin ACFs and identify the barriers to optimal pain management.An exploratory descriptive qualitative study using semistructuredinterviews. Five Southern Tasmania, Australian ACFs. 23 staff members(18 nurses and 5 facility managers). Interviews were conductedfrom September to November 2015. Interviews included questionsabout how pain was measured or assessed, what happened if pain wasidentified, barriers to pain management, and potential ways to overcomethese barriers. Interviewees noted that there were no formalrequirements regarding pain assessment at the ACFs reviewed; however,pain was often informally assessed. Staff noted the importanceof adequate pain management for the residents’ quality of life andemployed both nonpharmacologic and pharmacologic techniques toreduce pain when identified. The barriers to optimal pain managementincluded difficulty identifying and assessing pain, residents’resistance to reporting pain and/or taking medications, andcommunication barriers between the nursing staff and GPs. Staff interviewedwere dedicated to managing residents’ pain effectively;however, actions in a number of areas could improve resident outcomes.These include a more consistent approach to documentingpain in residents’ progress notes and improving nurse-GP communicationsto ensure that new or escalating pain is identified andexpedient changes can be made to the resident’s management. Additionally,resident, family, nurse, and carer education, conductedwithin the facilities on a regular basis, could help improve the painmanagement of residents.

Item Type: Article
Authors/Creators:Veal, FC and Williams, M and Bereznicki, L and Cummings, EA and Thompson, A and Peterson, G and Winzenberg, T
Keywords: pain, elderly, aged care facility
Journal or Publication Title: Pain Management Nursing
Publisher: W.B. Saunders Co.
ISSN: 1524-9042
DOI / ID Number: 10.1016/j.pmn.2017.10.002
Copyright Information:

Copyright 2017 Published by Elsevier Inc. on behalf of the American Society for Pain Management Nursing

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